Is puberty getting earlier? The views of doctors and teachers.

AIMS: To determine the views of teachers, general practitioners (GPs) and paediatricians about whether there has been a recent change in the timing of the onset of puberty in children in the UK and in the timing of menarche in girls. DESIGN: Questionnaires were sent to a stratified random sample of each professional group. RESULTS: In relation to girls, almost 80% of teachers believe that the onset of puberty is occurring earlier and 73% feel that the menarche is occurring earlier. Those who had been working for longer than 10 years were more likely to say that the age of onset of puberty had decreased. GPs feel that both puberty and menarche are starting earlier, whereas paediatricians were evenly divided between those who thought puberty was starting earlier and those who thought that the timing had not changed. In boys, professionals generally believe that the timing of the onset of puberty has not altered significantly. CONCLUSION: Further study is required to determine whether puberty is really occurring earlier in girls.

The ascending testis: is late orchidopexy due to failure of screening or late ascent?

It is widely recommended that infant boys with undescended testes (UDT) should be referred for surgical opinion before the age of 18 months. To attempt to identify the reasons why the mean age at orchidopexy in our institution was as high as 5.5 years, a retrospective review of the screening history, examinations, and management of boys over the age of 3 years at the time of orchidopexy was undertaken by reference to community, general practitioner, and hospital records. In 36 children where hospital and community records giving information prior to referral were available, the UDT had previously been documented on at least one occasion as descended in 24 children or retractile in 10. In 1 child there was delayed referral, and in another, there was operative delay. It is concluded that there is either frequent failure of the Child Health Surveillance screening programme, or that late ascent of a testis previously sited in the scrotum is a common occurrence. We recommend further prospective studies to clarify this latter phenomenon.

Latex agglutination testing in bacterial meningitis.

The value of the latex agglutination test in meningitis was assessed. This was positive in 60% cases of Streptococcus pneumoniae, 93% of Haemophilus influenzae type b, and 39% of Neisseria meningitidis infections. We cannot support the view that this test was more valuable than Gram staining in partially treated meningitis and cannot recommend its routine use. It may, however, be valuable if Gram staining does not identify an organism or if it suggests meningococcal infection.

When is it safe for babies to swim?

What factors are important when health professionals are asked "At what age is it safe to take my baby swimming in a public pool?". In a survey of primary health care doctors, no unified approach was identified but many considered immunisation essential before swimming. There is no evidence to support this view. Careful attention to the infant's body temperature is more important.

Current concepts of the aetiology of SIDS.

Sudden infant death syndrome (SIDS) is the major cause of death in infancy after the first week of life. Despite much research, its precise pathophysiology remains unknown. In this article, current concepts of the aetiology of the condition are discussed.

Confirmation of the assignment of human biliverdin reductase to chromosome 7.

Segregation of biliverdin reductase (BLVR) in 11 independent human-mouse hybrids confirms the assignment to chromosome 7 in man and gives a regional localization of 7pter----7q22. Isoelectric focusing of BLVR reveals genetically determined variation among inbred strains of mice.